Chicago Ambulatory Care Center, LTD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

036105483 Issued in IL

Legal business name

CHICAGO AMBULATORY CARE CENTER, LTD

Practice address

1044 N Mozart St
Ste - 402
Chicago, IL 60622-2789

Phone

(773) 292-4501

NPI assigned

Aug 5, 2012

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. George Thomas Ampalloor, M.DNPI 1194733584

Title

President

Phone

(773) 292-4501

Specialties & licenses 1

Addresses

Other identifiers 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• George Thomas Ampalloor, MD

  • Pediatrics Physician
  • Chicago, IL
  • NPI 1194733584
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1344124800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1631318400000",
    "number": "1821345208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1044 N MOZART ST",
            "address_2": "STE - 402",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606222789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1044 N MOZART ST",
            "address_2": "STE - 402",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606222789",
            "telephone_number": "773-292-4501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHICAGO AMBULATORY CARE CENTER, LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-05",
        "last_updated": "2021-09-11",
        "certification_date": "2021-09-11",
        "status": "A",
        "authorized_official_last_name": "AMPALLOOR",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_middle_name": "THOMAS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "773-292-4501",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036105483",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036105483",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Pediatrics Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• Pediatrics Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.